Programme Prevent-Teach-Reinforce : une intervention comportementale pour diminuer les comportements problématiques en milieu scolaire.

Cet article a pour but de décrire le programme d’intervention Prevent-Teach-Reinforce (PTR; Dunlap et al., 2010) en mettant l’accent sur les théories béhaviorales sous-jacentes qui ont servi à son développement. Le PTR est un programme visant la diminution des comportements problématiques chez les enfants et les adolescents en milieu scolaire qui est basé sur l’évaluation fonctionnelle pour développer une intervention individualisée et intensive. Nous effectuons une analyse critique afin de proposer un protocole de validation scientifique puisque le programme n’a fait l’objet que d’une seule évaluation randomisée. Les implications pour la pratique clinique sont aussi discutées en mettant l’accent sur le rôle du psychologue dans l’implantation de ce programme.

Managing risk in a large rural electrification programme in India

Rural electrification projects and programmes in many countries have suffered from design, planning, implementation and operational flaws as a result of ineffective project planning and lack of systematic project risk analysis. This paper presents a hierarchical risk-management framework for effectively managing large-scale development projects. The proposed framework first identifies, with the involvement of stakeholders, the risk factors for a rural electrification programme at three different levels (national, state and site). Subsequently it develops a qualitative risk prioritising scheme through probability and severity mapping and provides mitigating measures for most vulnerable risks. The study concludes that the hierarchical risk-management approach provides an effective framework for managing large-scale rural electrification programmes. © IAIA 2007.

Communities of implementation

The concept of communities of practice (CoPs) has rapidly gained ground in fields such as knowledge management and organisational learning since it was first identified by Lave and Wenger (1991) and Brown and Duguid (1991). In this article, we consider a related concept that we have entitled “communities of implementation.” Communities of implementation (CoIs) are similar to communities of practice in that they offer an opportunity for a collection of individuals to support each other and share knowledge in a dynamic environment and on a topic in which they share interest. In addition, and to differentiate them from CoPs, a community of implementation extends the responsibilities of a CoP by having as its focus the implementation of a programme of change. This may well extend to designing the change programme. Thus, whereas a main purpose of a CoP is to satisfy “a real need to know what each other knows” (Skyrme, 1999) in an informal way, we argue that a main purpose of a community of implementation is to “pool individual knowledge (including contacts and ways of getting things done) to stimulate collective enthusiasm in order to take more informed purposeful action for which the members are responsible.” Individual and collective responsibility and accountability for successfully implementing the actions/change programme is a key feature of a community of implementation. Without these pressures the members might lower the priority of implementation, allowing competing priorities to dominate their attention and resources. Without responsibility and accountability, the result is likely to be (at best) an organisation which has not begun a change programme, or (at worst) an organisation which is stuck halfway through another failing initiative. To achieve these additional objectives beyond those of a CoP, the CoI needs to provide heightened support to its members. In fact often the members will collectively strategise the development and implementation of the change programme they are leading in the organisation. Other concepts similar to CoPs have appeared in the literature, for example “communities of knowing” (Boland & Tenkasi, 1995), but none have a specific focus on implementation. Perhaps the closest example of a CoI, as suggested by our definition, is reported by Karsten, Lyytinen, Hurskainen, and Koskelainen (2001) who describe a CoP in a paper machinery manufacturer which seems to have the necessary focus on implementation. The theoretical aspects of this article will explore the relationship between CoPs and CoIs, and the needs for different arrangements for a CoI. The practical aspect of this article will consist of a report on a case study of a CoI that was successful in its implementation of a programme of change that aimed to improve its organisation’s knowledge management activities. Over two years the CoI implemented a suite of complementary actions across the organisation. These actions transformed the organisation and moved it towards achieving its ‘core values’ and overall objectives. The article will explore: the activities that formed and gelled the community, the role of the community in the implementation of actions, and experiences from key members of this community on its success and potential improvements.

Privatization : problems of implementation in Egypt

This study aims to investigate to what extent the views of the managers of the enterprises to be privatized are a barrier to smooth implementation of privatization as opposed to other problems. Accordingly, the research tackles two main issues: Identification and analysis of the major problems encountered in the implementation of the Egyptian privatization programme and at which level these problems exist while proposing different approaches to tackle them; and views of public sector top and middle-level managers regarding the main issues of privatization. The study relies upon a literature survey, interviews with stakeholders, a survey of managers' attitudes and several illustrative case studies. A model of "good practice" for the smooth and effective implementation of privatization has been designed. Practice in Egypt has then been studied and compared with the "good practice" model. Lack of strictness and firmness in implementing the announced privatization programme has been found to be a characteristic of Egyptian practice. This is partly attributable to the inadequacy of the programme and partly to the different obstacles to implementation. The main obstacles are doubtful desirability of privatization on the part of the managers at different implementation levels, resistance of stakeholders, in adequately of the legal framework governing privatization, redundant labour, lack of an efficient monitoring system allowing for accountability, inefficient marketing of privatization, ineffective communication, insufficient information at different levels and problems related to valuation and selling procedures. A large part of the thesis is concerned with SOE (State Owned Enterprise) managers' attitudes on and understanding of the privatization (appraised through surveys). Although most managers have stated their acceptance of privatization, many of their responses show that they do not accept selling SOEs. They understand privatization to include enterprise reform and restructuring, changing procedures and giving more authority to company executives, but not necessarily as selling SOEs. The majority of managers still see many issues that have to be addressed for smooth implementation of privatization e.g. insufficiency of information, incompleteness of legal framework, restructuring and labour problems. The main contribution to knowledge of this thesis is the study of problems of implementing privatization in developing countries especially managers' resistance to privatization as a major change, partly because of the threat it poses and partly because of the lack of understanding of privatization and implications of operating private businesses. A programme of persuading managers and offsetting the unfavourable effects is recommended as an outcome of the study. Five different phrases and words for the national Index to theses are: Egypt, privatization, implementation of privatization, problems of implementing privatization and managers' attitudes towards privatization.

Risk management in enterprise resource planning implementation:a new risk assessment framework

Enterprise resource planning (ERP) projects are risky. But if they are implemented appropriately, they can provide competitive advantage to organisations. Therefore, ERP implementation has become one of the most critical aspects of today's information management research. The main purpose of this article is to describe a new ERP risk assessment framework (RAF) that can be used to increase the success of ERP implementation. In this article, through a case study based in a leading UK-based energy service provider, we demonstrate the new RAF, which has been shown to help identify and mitigate risks in ERP implementation. In contrast to other research, this RAF identifies risks hierarchically in external engagement, programme management, work stream and work package levels across technical, schedule, operational, business and organisational categories. This not only helped to develop responses to mitigate risks but also facilitates on-going risk control.

Total productive maintenance implementation in the newspaper printing industry:an action research approach

The objective of Total Productive Maintenance (TPM) is to maximise plant and equipment effectiveness, to create a sense of ownership for operators, and promote continuous improvement through small group activities involving production, engineering and maintenance personnel. This paper describes and analyses a case study of TPM implementation at a newspaper printing house in Singapore. However, rather than adopting more conventional implementation methods such as employing consultants or through a project using external training, a unique approach was adopted based on Action Research using a spiral of cycles of planning, acting observing and reflecting. An Action Research team of company personnel was specially formed to undertake the necessary fieldwork. The team subsequently assisted with administering the resulting action plan. The main sources of maintenance and operational data were from interviews with shop floor workers, participative observation and reviews conducted with members of the team. Content analysis using appropriate statistical techniques was used to test the significance of changes in performance between the start and completion of the TPM programme. The paper identifies the characteristics associated with the Action Research method when used to implement TPM and discusses the applicability of the approach in related industries and processes.

London's Olympic ambassadors:a legacy for public policy implementation

As a contribution to current discussions about securing a legacy from the 2012 Olympic and Paralympic Games, this article considers whether there are lessons for public policy implementation around volunteer involvement. Drawing on the case of the Team London Ambassadors Programme which encompassed 8,000 volunteers during the Games period, the article considers the scope for an expanded role for UK public sector organisations in the recruitment, training and management of volunteers in the future.

GPs' perspectives on managing the NHS Health Check in primary care:a qualitative evaluation of implementation in one area of England

OBJECTIVES: To evaluate the implementation of the National Health Service (NHS) Health Check programme in one area of England from the perspective of general practitioners (GPs). DESIGN: A qualitative exploratory study was conducted with GPs and other healthcare professionals involved in delivering the NHS Health Check and with patients. This paper reports the experience of GPs and focuses on the management of the Heath Check programme in primary care. SETTING: Primary care surgeries in the Heart of Birmingham region (now under the auspices of the Birmingham Cross City Clinical Commissioning Group) were invited to take part in the larger scale evaluation. This study focuses on a subset of those surgeries whose GPs were willing to participate. PARTICIPANTS: 9 GPs from different practices volunteered. GPs served an ethnically diverse region with areas of socioeconomic deprivation. Ethnicities of participant GPs included South Asian, South Asian British, white, black British and Chinese. METHODS: Individual semistructured interviews were conducted with GPs face to face or via telephone. Thematic analysis was used to analyse verbatim transcripts. RESULTS: Themes were generated which represent GPs' experiences of managing the NHS Health Check: primary care as a commercial enterprise; 'buy in' to concordance in preventive healthcare; following protocol and support provision. These themes represent the key issues raised by GPs. They reveal variability in the implementation of NHS Health Checks. GPs also need support in allocating resources to the Health Check including training on how to conduct checks in a concordant (or collaborative) way. CONCLUSIONS: The variability observed in this small-scale evaluation corroborates existing findings suggesting a need for more standardisation. Further large-scale research is needed to determine how that could be achieved. Work needs to be done to further develop a concordant approach to lifestyle advice which involves tailored individual goal setting rather than a paternalistic advice-giving model.

Perceptions and experiences of the implementation, management, use and optimisation of electronic prescribing systems in hospital settings:protocol for a systematic review of qualitative studies

Introduction: There is increasing evidence that electronic prescribing (ePrescribing) or computerised provider/physician order entry (CPOE) systems can improve the quality and safety of healthcare services. However, it has also become clear that their implementation is not straightforward and may create unintended or undesired consequences once in use. In this context, qualitative approaches have been particularly useful and their interpretative synthesis could make an important and timely contribution to the field. This review will aim to identify, appraise and synthesise qualitative studies on ePrescribing/CPOE in hospital settings, with or without clinical decision support. Methods and analysis: Data sources will include the following bibliographic databases: MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, Social Policy and Practice via Ovid, CINAHL via EBSCO, The Cochrane Library (CDSR, DARE and CENTRAL databases), Nursing and Allied Health Sources, Applied Social Sciences Index and Abstracts via ProQuest and SCOPUS. In addition, other sources will be searched for ongoing studies (ClinicalTrials.gov) and grey literature: Healthcare Management Information Consortium, Conference Proceedings Citation Index (Web of Science) and Sociological abstracts. Studies will be independently screened for eligibility by 2 reviewers. Qualitative studies, either standalone or in the context of mixed-methods designs, reporting the perspectives of any actors involved in the implementation, management and use of ePrescribing/CPOE systems in hospital-based care settings will be included. Data extraction will be conducted by 2 reviewers using a piloted form. Quality appraisal will be based on criteria from the Critical Appraisal Skills Programme checklist and Standards for Reporting Qualitative Research. Studies will not be excluded based on quality assessment. A postsynthesis sensitivity analysis will be undertaken. Data analysis will follow the thematic synthesis method. Ethics and dissemination: The study does not require ethical approval as primary data will not be collected. The results of the study will be published in a peer-reviewed journal and presented at relevant conferences.

Documenting the Contextualization and Implementation of mhGAP-HIG in Post-earthquake Nepal

Background: The burden of mental health is increased in humanitarian settings, and needs to be addressed in emergency situations. The World Health Organization has recently released the mental health Global Action Programme Humanitarian Intervention Guide (mhGAP-HIG) in order to scale up mental health service delivery in humanitarian settings through task-shifting. This study aims to evaluate, contextualize and identify possible barriers and challenges to mhGAP-HIG manual content, training and implementation in post-earthquake Nepal.

Methods: This qualitative study was conducted in Kathmandu, Nepal. Key informant interviews were conducted with fourteen psychiatrists involved in a mhGAP-HIG Training of Trainers and Supervisors (ToTS) in order to assess the mhGAP-HIG, ToTS training, and the potential challenges and barriers to mhGAP-HIG implementation. Themes identified by informants were supplemented by process notes taken by the researcher during observed training sessions and meetings.

Results: Key themes emerging from key informant interviews include the need to take three factors into account in manual contextualization: culture, health systems and the humanitarian setting. This includes translation of the manual into the local language, adding or expanding upon conditions prevalent in Nepal, and more consideration to improving feasibility of manual use by non-specialists.

Conclusion: The mhGAP-HIG must be tailored to specific humanitarian settings for effective implementation. This study shows the importance of conducting a manual contextualization workshop prior to training in order to maximize the feasibility and success in training health care workers in mhGAP.

Facteurs susceptibles d’influencer l'implantation de l'Échelle québécoise des niveaux de compétence en français des personnes immigrantes adultes et du Programme-cadre de français pour les personnes immigrantes adultes au Québec

La coexistence des services de francisation au Québec pour les personnes immigrantes adultes a fait l'objet de divers enjeux liés notamment au passage des apprenants d'un lieu de formation à un autre (Québec, MICC, 2011a). Dans le but de répondre à ces enjeux et d’harmoniser l'offre de services gouvernementaux en matière de francisation des adultes, le ministère de l'Immigration et des Communautés culturelles (MICC) a élaboré en collaboration avec le ministère de l'Éducation, du Loisir et du Sport (MELS), une innovation pédagogique, soit un référentiel commun québécois composé de deux instruments : l’Échelle québécoise des niveaux de compétence en français des personnes immigrantes adultes et le Programme-cadre de français pour les personnes immigrantes adultes au Québec. Le but de notre étude était de mieux comprendre l'implantation du référentiel commun québécois, de faire état des représentations du personnel enseignant en francisation vis-à-vis de cette innovation pédagogique et d’identifier les principaux facteurs qui structurent son implantation. Pour atteindre ces objectifs de recherche, nous avons mené une étude qualitative dans laquelle nous nous sommes appuyée sur le modèle d'implantation de Vince-Whitman (2009) qui identifie douze facteurs facilitant l’implantation d’une politique et d’une pratique. Nous avons accédé aux représentations de douze enseignantes et enseignants en francisation qui œuvrent au MICC et au MELS lors d’entretiens de groupe en leur permettant de s'exprimer sur leurs pratiques pédagogiques et sur leurs impressions du référentiel commun québécois. À l’aide du logiciel QSF NVivo 8, nous avons analysé le contenu des propos de nos participants de recherche. Nos résultats démontrent que le manque appréhendé de ressources – humaines, matérielles et financières, et un manque de temps, de formation et de collaboration professionnelle pourraient représenter des obstacles et nuire à une éventuelle implantation du référentiel commun québécois. À la lumière de ces résultats, nous proposons un cadre de référence composé de sept facteurs d’implantation d’une innovation pédagogique afin de mieux rendre compte d’une réalité spécifique et contemporaine, celle de l'implantation du référentiel commun québécois pour la francisation des immigrants adultes scolarisés. Les écrits scientifiques et nos résultats de recherche démontrent que de diverses formes de soutien, principalement du matériel pédagogique approprié et suffisant, peuvent constituer un facteur-clé dans la réussite de l’implantation d’une innovation pédagogique.

Brazilian Social Segurity and Social Work: reflections on the Continuous Cash Benefit Programme

Guaranteed under the Federal Constitution of 1988, Brazilian social security covers rights relating to health, social welfare and social care. The Continuous Cash Benefit Programme (BPC) was approved as part of social care policy and is regulated under the Social Care Act (Ley Orgánica de Asistencia Social) of 1993. This benefit guarantees a minimum monthly income for persons with disabilities and for older adults. Certain requirements must be satisfied in order to obtain the assistance: medical and social assessment of disabled persons, a minimum age of 65 years for older adults, and, in both cases, the value of per capita income for the nuclear family in question, which must be lower than a quarter of the minimum wage. Regulation of the BPC has incorporated advances and setbacks in terms of legislation and implementation. In this framework, this article presents a theoretical reflection, an analysis of the legislation on the matter, and some reflections on the challenges that it poses for social workers.

An implementation architecture for scenario-based simulations

The past years have witnessed an increased use of applied games for developing and evaluating communication skills. These skills benefit from in-terpersonal interactions. Providing feedback to students practicing communica-tion skills is difficult in a traditional class setting with one teacher and many students. This logistic challenge may be partly overcome by providing training using a simulation in which a student practices with communication scenarios. A scenario is a description of a series of interactions, where at each step the player is faced with a choice. We have developed a scenario editor that enables teachers to develop scenarios for practicing communication skills. A teacher can develop a scenario without knowledge of the implementation. This paper presents the implementation architecture for such a scenario-based simulation.

Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5)

Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initiative between the Reference site MACVIA-LR (Contre les MAladies Chroniques pour un VIeillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (3) Commitments for Action to the European Innovation Partnership on Active and Healthy Ageing and the AIRWAYS ICPs network. It is deployed in collaboration with the World Health Organization Global Alliance against Chronic Respiratory Diseases (GARD). The European Innovation Partnership on Active and Healthy Ageing has proposed a 5-step framework for developing an individual scaling up strategy: (1) what to scale up: (1-a) databases of good practices, (1-b) assessment of viability of the scaling up of good practices, (1-c) classification of good practices for local replication and (2) how to scale up: (2-a) facilitating partnerships for scaling up, (2-b) implementation of key success factors and lessons learnt, including emerging technologies for individualised and predictive medicine. This strategy has already been applied to the chronic respiratory disease action plan of the European Innovation Partnership on Active and Healthy Ageing.

Étude d’évaluabilité et évaluation des processus et des effets d’un programme de prévention de l’usage de substances psychoactives lors de la transition primaire-secondaire

La mise en œuvre d’activités de prévention de la consommation de substances psychoactives (SPA) (tabac, alcool et cannabis) en milieu scolaire est une stratégie couramment utilisée pour rejoindre un grand nombre de jeunes. Ces activités s’inspirent, soit de programmes existant, soit d’innovations dictées par le contexte d’implantation ou l’existence de données de recherche. Dans un cas comme dans l’autre, l’évaluation de ces programmes représente la meilleure voie pour mesurer leur efficacité et/ou connaître comment ceux-ci sont implantés. C’est cet impératif qui a motivé une commission scolaire du Québec a recommandé l’évaluation de l’Intervention en Réseau (IR), un programme développé en vue de retarder l’âge d’initiation et de réduire la consommation problématique de SPA chez les élèves. Ce programme adopte une approche novatrice avec pour principal animateur un intervenant pivot (IP) qui assure le suivi des élèves de la 5e année du primaire jusqu’en 3e secondaire. Inspiré des modèles en prévention de la santé et de l’Approche École en santé (AES), le rôle de l’IP ici se démarque de ceux-ci. Certes, il est l’interface entre les différents acteurs impliqués et les élèves mais dans le cadre du programme IR, l’IP est intégré dans les écoles primaires et secondaires qu’il dessert. C’est cet intervenant qui assure la mobilisation des autres acteurs pour la mise en œuvre des activités. Cette thèse vise à rendre compte de ce processus d’évaluation ainsi que des résultats obtenus. L’approche d’évaluation en est une de type participatif et collaboratif avec des données quantitatives et qualitatives recueillies par le biais de questionnaires, d’entrevues, de groupes de discussion, d’un journal de bord et de notes de réunions. Les données ont été analysées dans le cadre de trois articles dont le premier concerne l’étude d’évaluabilité (ÉÉ) du programme. Les participants de cette ÉÉ sont des acteurs-clés du programme (N=13) rencontrés en entrevues. Une analyse documentaire (rapports et journal de bord) a également été effectuée. Cette ÉÉ a permis de clarifier les intentions des initiateurs du programme et les objectifs poursuivis par ces derniers. Elle a également permis de rendre la théorie du programme plus explicite et de développer le modèle logique, deux éléments qui ont facilité les opérations d’évaluation qui ont suivi. Le deuxième article porte sur l’évaluation des processus en utilisant la théorie de l’acteur-réseau (TAR) à travers ses quatre moments du processus de traduction des innovations (la problématisation, l’intéressement, l’enrôlement et la mobilisation des alliés), l’analyse des controverses et du rôle des acteurs humains et non-humains. Après l’analyse des données obtenues par entrevues auprès de 19 informateurs-clés, les résultats montrent que les phases d’implantation du programme passent effectivement par les quatre moments de la TAR, que la gestion des controverses par la négociation et le soutien était nécessaire pour la mobilisation de certains acteurs humains. Cette évaluation des processus a également permis de mettre en évidence le rôle des acteurs non-humains dans le processus d’implantation du programme. Le dernier article concerne une évaluation combinée des effets (volet quantitatif) et des processus (volet qualitatif) du programme. Pour le volet quantitatif, un devis quasi-expérimental a été adopté et les données ont été colligées de façon longitudinale par questionnaires auprès de 901 élèves de 5e et 6e année du primaire et leurs enseignants de 2010 à 2014. L’analyse des données ont montré que le programme n’a pas eu d’effets sur l’accessibilité et les risques perçus, l’usage problématique d’alcool et la polyconsommation (alcool et cannabis) chez les participants. Par contre, les résultats suggèrent que le programme pourrait favoriser la réduction du niveau de consommation et retarder l’âge d’initiation à l’alcool et au cannabis. Ils suggèrent également un effet potentiellement positif du programme sur l’intoxication à l’alcool chez les élèves. Quant au volet qualitatif, il a été réalisé à l’aide d’entrevues avec les intervenants (N=17), de groupes de discussion avec des élèves du secondaire (N=10) et d’une analyse documentaire. Les résultats montrent que le programme bénéficie d’un préjugé favorable de la part des différents acteurs ayant participé à l’évaluation et est bien acceptée par ces derniers. Cependant, le roulement fréquent de personnel et le grand nombre d’écoles à suivre peuvent constituer des obstacles à la bonne marche du programme. En revanche, le leadership et le soutien des directions d’écoles, la collaboration des enseignants, les qualités de l’IP et la flexibilité de la mise en œuvre sont identifiés comme des éléments ayant contribué au succès du programme. Les résultats et leur implication pour les programmes et l’évaluation sont discutés. Enfin, un plan de transfert des connaissances issues de la recherche évaluative est proposé.